The World Health Organization lashed out at Israel on Tuesday for ignoring Palestinians' right to health by denying/delaying travel permits for critically ill Gaza Strip residents.
Ambrogio Manenti, who heads the WHO's West Bank and Gaza office, said case studies of patients who died while waiting for permits to travel to Israel for treatment "show nonsense, inhumanity and, at the end, tragedy".
"The right to health appears to be optional for Palestinians," he added.
The UN agency cited the case of Amir al-Yazji, nine, who died of meningeal encephalitis at a hospital in Gaza in November after his family faced one hurdle after another to get a travel permit only to have authorities deny the documents to the ambulance team at the last minute.
Tertiary health care is virtually unavailable in the Palestinian territories and a strict permit system limits patients' access to hospitals in Israel, the report said.
But Israel says it issued more than 7,200 permits last year for patients to travel out of Gaza for medical reasons, and insists it gives high priority to patients who need treatment.
The cases highlighted by the WHO study show critically ill patients and their families going through an often nightmarish process to obtain the permits, which in some cases are denied "for security reasons."
The situation is particularly acute in the Hamas-run Gaza Strip, where Israel has imposed a crippling blockade since June, in what the Jewish state says is an attempt to halt rocket fire from the territory.
The blockade has led to a sharp deterioration in access to health services and medicine, in what amounts to "collective punishment of the weakest," the WHO report said.
Manenti said Amir is a case in point.
After the young boy was admitted to hospital on November 5, doctors ordered a computer-aided tomography as he did not respond to antibiotic treatment.
But the CT scanner needed repairs, something that couldn't be done until November 10 due to a shortage of parts resulting from the closure of Gaza.
After eventually finding a lesion on the anterior wall of the brain, doctors decided Amir needed specialist care in Israel.
The boy's father obtained an urgent referral, but for days he could not get a permit for his son to go through the Erez crossing into Israel despite what he said were "hundreds of phone calls."
As Amir's condition deteriorated dramatically, authorisation eventually came through on November 18. But the doctor and two nurses who were to travel in the ambulance with the boy up to the crossing were denied access to Erez.
"Five different teams ... were refused," the report said.
After one team finally got the green light, authorities gave the patient 15 minutes to get to Erez, but medical staff decided to wait until the next day since they needed one hour to ready the boy and the ambulance.
At 7:45 am on November 19, Amir was dead.
That, says Manenti, was one of several "tragedies that could and should have been avoided."
Between October 1 and March 2, 32 patients died in Gaza after the permits they requested were delayed or refused, the WHO said.
The number of patients who were denied permits rose from just over three percent in January 2006 -- when the Islamist Hamas movement won Palestinian parliamentary elections -- to almost 36 percent in December 2007.
"From a health perspective this is something unacceptable. I think my organisation should stigmatise this behaviour," said Manenti.
But Captain Shadi Yasin of the Israeli military liaison office for Gaza insisted the WHO report was "completely wrong."
Israel "gives high priority for all urgently needed treatment in Israel and the West Bank for Gaza people and for the entry into Gaza of medicine and medical supplies," the spokesman said.